Study: Southern U.S. home of high-risk ‘diabetes belt'

Published 12:03 am, Thursday, March 10, 2011

In the 1960s, a group of U.S. states with high age-adjusted stroke mortality defined a "stroke belt." Until recently, geographic patterns of diabetes had not been specifically characterized in the same manner.

In an article published in the April 2011 issue of the American Journal of Preventive Medicine, researchers were able to identify clustered high prevalence areas, or a "diabetes belt" of 644 counties in 15 mostly southeastern states using data compiled for the first time of estimates of the prevalence of diagnosed diabetes for every U.S. county.

Nearly one third of the difference in diabetes prevalence between the diabetes belt and the rest of the U.S. is associated with sedentary lifestyle and obesity. Thirty percent of the excess risk was associated with modifiable risk factors, and 37 percent with nonmodifiable factors, such as age and race or ethnicity.

Data from the diabetes belt showed prevalence rates greater than 11.0% or higher. By comparing demographics and risk factors such as gender, age, education, sedentary lifestyle, obesity, and race/ethnicity, they found four factors that distinguished the diabetes belt from the rest of the country.

— Population of the diabetes belt counties contained substantially more non-Hispanic African Americans compared to the rest of the country (23.8 percent for the diabetes belt, 8.6 percent for the rest of the country);

— Prevalence of obesity (32.9 percent vs. 26.1 percent) was greater in the diabetes belt than in the rest of the U.S.;

— Sedentary lifestyle (30.6 percent vs. 24.8 percent) was greater in the diabetes belt than in the rest of the U.S.; and

— Proportion of people with a college degree was smaller (24.1 percent vs. 34.3 percent).

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Some 644 counties make up the diabetes belt. This belt includes portions of the states of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and West Virginia, as well as the entire state of Mississippi.

According to Barker, "People who live in the diabetes belt will reduce their chance of developing type 2 diabetes if they are more active physically and, for those who are overweight or obese, if they lose weight. Taking these steps will eventually lower the prevalence of diabetes within the diabetes belt."